Post-tetanic count and single twitch height at the onset of reflex movement after administration of vecuronium under different types of anaesthesia

We have studied post-tetanic count (PTC) and single twitch heightat the onset of reflex movement to carinal stimulation afteradministration of vecuronium with five different types of anaesthesia.Seventy-five adult patients were allocated randomly to fivegroups of 15 patients each, to receive one of the followinganaesthetics: neuroleptanaesthesia (fentanyl and droperidol)or 1 MAC of either halothane, isoflurane, enflurane or sevofluranewith 66% nitrous oxide in oxygen. During spontaneous recoveryfrom vecuronium-induced neuromuscular block, the carina wasstimulated with a suction catheter every 150 s. Single twitchheights at the onset of reflex movement were similar (2.0–2.7%of control values) between the five groups. In contrast, PTCat the onset of reflex movement to carinal stimulation differed(7.4–17.0) between groups.     

Abnormal cardiac histology in severe intrauterine growth retardation infants

Four infants with severe intrauterine growth retardation (IUGR) weighing less than 1000 g at birth developed heart failure and died in our unit, where heart failure of IUGR infants is the main reason of death in extremely low birth-weight infants. The causes of their heart failure are one of the main themes in current neonatal medicine. The subjects of this study were four small for gestational age infants; all died due to heart failure 5 to 10 days after birth. Microscopic specimens of hearts from autopsies were evaluated with respect to the following characteristics: thickness of myocardial fibers, maturation of nuclei, presence of dysgenesis or necrosis in myocardium, and amount of glycogen in the heart. Neither dysgenesis nor infarction of the heart was found but hypoplasia in myocardial fibers and decreased glycogen levels were observed. Maturation delay in myocytes' nuclei did not appear to be severe. We conclude that these infants' hearts failed to adapt to postnatal hemodynamic changes because of inadequate myocardial function and inadequate glycogen reserves.     

Changes in work performances in obstructive sleep apnea patients after dental appliance therapy

Abstract The effects of dental appliances on work performances of obstructive sleep apnea syndrome (OSAS) is not well examined. This study evaluated the polysomnographic and psychological findings before and after therapy. Nine patients were diagnosed OSAS by nocturnal polysomnography. The psychological battery was performed from 13:00 to 14:00, which consisted of Uchida-Kraepelin psychodiagnostic test (U-K's test) and Bourdon's cancellation test (Bourdon's test). Approximately 3 months after the treatment, the examinations were performed. Apnea and desaturation index decreased significantly after the therapy. In addition, sleep architecture improved after the therapy compared with that before the therapy. Dysfunction of task performances, such as mean level of work amounts in U-K's test, mean error, mean performance time and mean deviation in Bourdon's test improved after therapy. We conclude that dental appliances therapy is effective not only to apnea but also to work performance in OSAS.     

Exercise-induced ventricular tachycardia without demonstrable heart disease in childhood

Exercise-induced ventricular tachycardia (VT) without demonstrable heart disease was studied in pediatric patients. The study population consisted of 17 patients aged 5–14 years (average 9.1 years), who demonstrated reproducible VT during or immediately after exercise testing using a treadmill. The main reasons for the exercise testing were episodes of exercise-related syncope in two patients, exercise-related palpitation in seven and evaluation of sporadic ventricular premature contraction (VPC) in eight. Of the eight patients in the asymptomatic group, two developed sustained VT and the other six had non-sustained VT. Of the nine patients in the symptomatic group, six developed sustained VT. Verapamil produced a good response in seven of 14 patients, and propranolol in six. None of the patients died during the follow-up period, an average of 59.6 months. In four patients, both VT and VPC disappeared, not only on exercise testing, but also on Holter electro-cardiograms, so the anti-arrhythmic agents were discontinued. One patient had syncope and convulsion caused by rapid bidirectional VT in the follow-up period. It was concluded that the prognosis of exercise-induced VT without demonstrable heart disease in children is relatively benign, but careful follow-up is required.     

Immunohistochemical Evaluation of Glucocorticoid Receptors in Developing Eyelids of NC-eob Mouse Fetuses with Genetically Determined Open-Eyelid Malformation

NC-eob mice are mutants having open eyelids at birth. Previous studies have revealed that this defect is related to the absence of epidermal differentiation at the tip of the developing eyelids on gestation day (GD) 16, and that maternal treatment with cortisone acetate (CA), a glucocorticoid compound, which has an ability to accelerate epidermal differentiation, is not effective against the epithelium in NC-eob fetuses although the eyelid growth is slightly enhanced. In this study, transverse sections of the eyelids of NC-eob fetuses on GDs 14 and 15 were evaluated immunohistochemically for glucocorticoid receptors (GRs) by using coisogenic NC fetuses as a control. For comparison, GRs in the palate were also investigated. On GD 14, the GR density in both the epithelium and mesenchyme of the eyelids was comparable between NC-eob and NC fetuses. On GD 15, on the other hand, the GR density in the mesenchyme was significantly lower in NC-eob than in NC, while no such change was found in the epithelium. The GR density in the palate of NC-eob fetuses was comparable to that of NC fetuses in both the epithelium and mesenchyme on any of the gestation days examined. These results suggest that the low density of GR in the eyelid mesenchyme of NC-eob fetuses on GD 15 may be one of the reasons for the insufficient development of the eyelids after treatment of their mothers with CA.     

Pyrimethamine Teratogenesis by Short Term Administration in Goettingen Miniature Pig

Pyrimethamine was mixed with mashed feed and given to pregnant sows of Goettingen miniature pig through a part of the period of organogenesis. A high incidence of the major malformations such as cleft palate, club foot and micrognathia was observed in 13 out of 24 newborns from 5 pregnants which a teratogenic dose (3.6 mg/kg of body weight/day) from day 11 to day 22 of gestation, the first half of the organogenetic period. Only one cleft palate was observed among the 23 newborns from 4 pregnants administered the same dose through the second half of the period. Among the 51 newborns from 10 pregnants which the same dose through the first or second quarter, only 4 newborns showed external major malformations. However, 19 out of 38 live newborns without external major malformations in these groups died within 2 days after birth. Clinical symptoms of these neonatally dead young were similar to splayleg, a naturally occurring functional anomaly in pigs. No internal malformation was revealed by the autopsy of these dead newborns.     

Delay in the Development of the Secondary Palate in Ay/a Mouse Embryos

The effects of the A^y gene on the normal development were investigated by using a inbred strain of C57BL/6 (a/a) and its congenic strain of C57BL/6-A^y (A^y/a) mice. Three mating groups (female× male), i. e., group I, a/a × a/a; group II, a/a × A^y/a; and group III, A^y/a × a/a, were set, and the rating of normal development was compared among the groups on gestation days 13, 14, 15 or 16 with special attention to the secondary palate. On day 13, the palates were wide-open and the palatal shelves were vertical in all embryos in all groups. In group I, both shelves became horizontal in 63.3% of the embryos on day 14. The incidences of embryos having completely closed palates were 95.8% and 100% on days 15 and 16, respectively. In group II, in which half of the embryos were expected to carry the A^y gene, the frequencies of shelf horizontalization on day 14 (31.1%) and of the complete closure on day 15 (74.3%) were significantly lowered as compared with those in group I, although the external morphological rating was comparable. On day 16, however, the palatal closure was completed in almost all embryos. In group III, in which maternal mice as well as half of their embryos carried the A^y gene, the external morphological rating was delayed as compared with that in either group I or II, and the frequencies of shelf horizontalization on day 14 and of the complete closure on day 15 were as low as 10.9% and 39.6%, respectively. The palatal closure was not yet completed in 15.3% of the embryos on day 16. These results indicate that the A^y gene causes a delay in shelf horizontalization and closure of the secondary palate of mouse embryos as compared with the a gene.